7 minute read
Polodoc: Precision in Decision
Dr.med. Andreas Krüger is a Swiss board orthopaedic and trauma surgeon in Zurich, who specialises in knee and shoulder surgery. Andi is a second generation of tournament doctors for equine sports, known as Polodoc since 2013
The correct diagnosis and the ideal treatment for the right patient in the right time frame results in a faster, better and longer performance for the athlete. This is exactly the opposite of a one drug or one treatment fits all approach.
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Precision medicine helps to better understand environment, lifestyle, and heredity factors that play a role in a player’s or patient’s life. With additional information gained, including through artificial intelligence
Precision in Decision
Boosting results with use of hyper individual knowledge
and machine learning, will make treatments as effective and safe as possible, or can even indicate how to prevent the illness from starting in the first place.
The challenge
– Identifying which approaches will be effective for which players based on genetic, environmental, and lifestyle factors. – How can we be smarter in decisionmaking? – How can we improve treatment results? – How can a person’s unique genomic portfolio help?
– Wider ability to use players’ genetic and other molecular information as part of routine check-up care for playing. – Improved ability to predict which treatments will work best for specific players. – Better understanding of the underlying mechanisms which cause various diseases/ injuries. – Improved approaches to preventing, diagnosing, and treating a wide range of diseases/injuries.
Pharmacogenomics is a part of precision medicine. Pharmacogenomics is the study of how genes affect a person’s response to particular drugs. This relatively new field combines pharmacology (the science of drugs) and genomics (the study of genes and their functions) to develop effective, safe medications and doses that are tailored to variations in a person’s genes.
Overall benefits
– Shift the emphasis in medicine from reaction to prevention – Predict susceptibility to disease/injury – Improve disease detection – Customize disease-prevention strategies
Mate contains 1.7 % caffeine in fresh leaves
Expert Opinion
Dr.med. Anna Erat, Hirslanden Checkup Center Zurich Like Maté?
• Maté contains 1.7 % caffeine in fresh leaves • Caffeine is the most widely consumed psychoactive substance in the world • Caffeine has been proven to be effective in enhancing performance and is not on the WADA doping list any longer • Albeit demographic and social factors have been linked to habitual caffeine consumption, twin studies show a large heritable component • Harvard scientists have identified a genetic propensity for coffee consumption. Two genes were identified that drive people to consume more or less caffeine • Genetic variants of CYP1A2 and
AHR determine whether caffeine may be harmful to you • By testing a difference between good and winning performance can be detected • Genetic variants, can determine how fast the body metabolizes caffeine and how and when to use it!
Check-up Zentrum Hirslanden Forchstrasse 420 8702 Zollikon CH +41 44 387 20 50 checkup@hirslanden.ch
Expert Opinion
Corina Sommer Vice President, Head US Technology Solutions GTM
IQVIA Msc. in Sport Sciences from the Swiss Institute of Technology, ETH, and an MBA in General Management from the IESE Business School The potential for AI/ML disease detection applications is unquestionably far-reaching due to Data empowered increasing sophistication for proper care with minimising negative outcomes of individual therapies.
Artificial intelligence (AI) is intelligence demonstrated by machines, as opposed to natural intelligence displayed by humans. The idea behind AI is that we let machines solve complicated tasks, and not just mechanical activity. While the theoretical concept of AI is more than 60-years-old, it only recently has evolved from theory to reality. This is because computational power and Machine Learning (ML) applications have made big advancements in the last 20 years. Machine learning is a part of artificial intelligence and uses algorithms and statistical models to make predictions or decisions without being explicitly programmed to do so. Moreover, the algorithms can adapt and improve automatically through experience and the use of data.
Imagine recognition, self-driving cars, voice assistants such as Amazon’s Alexa or Apple’s Siri, personalised advertisements, fraud detection in credit card transactions, or customer support done by chatbots all use Machine Learning algorithms. But ML algorithms are also widely used in medicine and have a significant impact.
Diagnosis and medical imaging are amongst the most wellknown applications of AI in medicine. Computers are great at analysing a vast amount of data and finding anomalies, and they do it much quicker than humans could. Hence the turn-around time is faster, and the time highly skilled personnel spends on studying medical images can be spent on direct patient interaction.
But what if we could use ML to prevent diseases and injuries? Today preventive care is mostly limited to routine physicals, vaccines, or dental cleanings, but with the help of ML we could potentially upgrade the current preventative care. Wearable fitness and medical devices like Apple Watch, Fitbit, or Garmin can collect a vast amount of healthcare data such as heart rate, VO2 and pulse oxidation, activity, sleep, nutrition, menstrual cycle, weight, blood pressure, and blood sugar. The data collected could be used to forecast health issues or sports injuries before they occur. Here, ML can help in analyzing the relationships between factors, detecting mechanisms leading to sports injuries, and selecting injury risk reduction approaches for individuals.
And what if our data from wearable sensors would be analysed in real-time and guide the user about what to (not) do? Or what if the data and its analysis could be shared with the user’s physician for a more in-depth medical understanding? This would help achieving a healthier life, higher quality of care, more cost-effectiveness and better outcomes. Technology is mostly ready for this, but data privacy is the key concern and will be one of the most important issues to address in the years to come. Once solved, we might be looking into a bright future with potentially no illnesses nor injuries thanks to the power of preventative medicine, enabled by ML and AI.
presentations can be detected with precise medicine. For example, Christian Eriksen the football player who collapsed during the EURO 2020 football match between Denmark and Finland and was saved from dying not like some victims before.
Transformative Technology
– Prescribe more effective drugs and avoid predictable negative side effects – Improve overall performance
Sounds quite easy but there is exactly the difficulty.
Some of us are may also be more different than others. Even being an identical twin there are still differences in details.
Benefits for players
Information on knowledge about a player’s unique genomic portfolio helps: – Information if vulnerable to certain diseases and how to avoid them – Allows athletes to reach their full potential through personalized training programs, nutrition, functional foods as well as supplements – Determines best tailored treatments when injury or disease occur.
Stop disease before it happens
Certain diseases like heart problems and some types of cancer can be quite accurately predicted by genomic analysis. For example, part of inherited arrhythmic disorders with unique genetic abnormalities and
Boost & optimise performance
Understanding how these small metabolic variations affect athletic performance is invaluable and can make the difference between a good performance and a great performance. One such example is blood sugar monitoring through biosensors. For instance, continuous glucose monitors (CGM) can report real-time blood sugar levels in the body during a workout or game and provide a unique opportunity to personalise the most effective fuelling strategy. When it comes to precision medicine and genetics, novel tests to determine your caffeine metabolism can truly open doors for boosting performance. This is particularly clear in sports such as Formula 1, since caffeine may improve performance by decreasing reaction time, sustaining maximum endurance and intermittent, high-intensity, long-duration exercise by extending the time until exhaustion. By testing for variants of the CYP1A2 gene, one can determine how fast the body metabolises caffeine and how, if and when to use it. Timing is everything!
Treat disease through precision medicine
Through careful pre-seasonal medical assessments, a trained sports physician can quickly determine if genetic testing is needed and whether targeted therapies should be initiated for conditions (inner organs, musculoskeletal). Similarly, people suffering from high cholesterol may need to take drugs such as statins to keep the cholesterol under control. Hence, genetic tests may be crucial to design the best possible therapies for patients and athletes alike. Targeted therapy at a molecular level indeed appears to be the path of the future.
For more information on Polodoc contact Andreas Krüger at drmedkrueger@gmail.com or www.polodoc.ch
